title: A clinical molecular genetic service for United Kingdom families with choroideraemia.
abstract: A diagnosis of choroideraemia (CHM) can be made clinically, based on the fundus examination and a family history consistent with X-linked inheritance. Molecular genetic testing offers a means of confirming the clinical diagnosis, establishing carrier status and allows presymptomatic diagnosis for families who wish to pursue these options. The aim of this study was to examine the uptake and assess the results from a diagnostic molecular genetics service for CHM. We have carried out a comprehensive audit of all molecular genetic results of UK NHS patients and families referred to the North West Regional Molecular Genetics Laboratory in Manchester, UK over a 55 month period. 110 people were referred to this service for testing including diagnostic, carrier and predictive requests. Putative pathogenic mutations were identified in 65/83 (78%) of male index cases. The identification of a familial pathogenic change enabled carrier testing in 16 asymptomatic females and predictive testing in 3 males. Case examples illustrate the range of cases referred for testing and also reflect the need for genetic counselling that results from offering a molecular diagnostic service such as this. Clinical molecular testing for CHM is available clinically and can be used to support the clinical diagnosis and management of patients with choroideraemia as well as their families. Case studies demonstrate the need to provide genetic testing to families and the potential clinical utility of testing.
authors.affiliation: Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, United Kingdom. simon.ramsden@cmft.nhs.uk
authors.forename: Simon C
authors.initials: SC
authors.lastname: Ramsden
authors.forename: Anna
authors.initials: A
authors.lastname: O'Grady
authors.forename: Tracy
authors.initials: T
authors.lastname: Fletcher
authors.forename: James
authors.initials: J
authors.lastname: O'Sullivan
authors.forename: Nikki
authors.initials: N
authors.lastname: Hart-Holden
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Barton
authors.forename: Georgina
authors.initials: G
authors.lastname: Hall
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Moore
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Webster
authors.forename: Graeme C
authors.initials: GC
authors.lastname: Black
mesh_terms: D048868:Adaptor Proteins, Signal Transducing / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015794:Choroideremia / Q000175:diagnosis* / Q000235:genetics*; D005260:Female; D005817:Genetic Counseling; D005820:Genetic Testing; D006579:Heterozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D019721:Ophthalmoscopes; D010375:Pedigree; D006113:United Kingdom; D055815:Young Adult
chemical_list: D048868:Adaptor Proteins, Signal Transducing; C081787:CHM protein, human
keywords: Choroideraemia (CHM); Molecular diagnostics; REP1